If you qualify for Medicaid in Florida, you do not get savings on a Marketplace plan. The Marketplace reviews your application, and if someone in your household looks eligible for Medicaid or CHIP, it sends your information to the state agency.
One application can open both doors. If you are weighing health insurance options for your family, here is what HealthCare.gov and the Florida DCF say about who decides, where you apply and which dates matter.
Who decides if you get Medicaid or Marketplace in Florida?
Your household income and each person’s situation decide. In Florida, the Department of Children and Families determines Medicaid eligibility, and Social Security determines it if you receive SSI. Medicaid follows federal rules, but the income counted, the coverage and the costs change from state to state, according to HealthCare.gov.
So your cousin’s case in another state does not predict yours. HealthCare.gov describes two paths to ask for Medicaid and CHIP. One is the Marketplace application, which forwards your information to the state when someone looks eligible. The other is going straight to the state Medicaid agency. Both are valid.
Medicaid has no season
You can apply for Medicaid and CHIP any time of year. There is no deadline and no window that closes in December. That is a big difference from the Marketplace, and it is worth knowing before you rush for the wrong reason.
How do you apply for Medicaid in Florida?
You apply online through ACCESS Florida, the DCF system at myaccess.myflfamilies.com, or you send the printed form by mail or fax to a Customer Service Center. The Florida Department of Children and Families keeps both paths open, so paper still works if computers are not your thing.
Have the income details ready for everyone who lives in your home and files with you.
Who the DCF lists as eligible
These are the groups the DCF names under family Medicaid:
- Children under 21.
- Pregnant women, within the income limits.
- Parents and relatives caring for children up to age 18.
- People who receive SSI, who qualify automatically.
Your children qualifying does not mean you qualify, and the reverse is also true. One household can end up with some members on Medicaid and others on a Marketplace plan.
Renewal comes with a notice
For renewal, the DCF sends a notice 45 days ahead. That envelope is not junk mail. If you moved and never updated your address with the DCF, the notice goes to the old house and you may find out late. Update your address in ACCESS Florida the week you move.
What income does the Marketplace look at for savings?
It looks at your estimated annual household income compared to the federal poverty level. HealthCare.gov states that premium tax credits apply to income between 100% and 400% of the federal poverty level. Below 100%, in states that did not expand Medicaid, some adults fall into a gap with no Medicaid and no premium tax credit.
Those are the adults who do not qualify through disability, age or other reasons. They earn too little for Marketplace savings and still do not meet Medicaid rules.
| Income range (% of the federal poverty level) | What applies according to HealthCare.gov |
|---|---|
| Below 100% | Probably no savings on a Marketplace plan, but Medicaid may apply. |
| Below 138% | If the state expanded Medicaid, Medicaid may apply. |
| Between 100% and 400% | In all states, the premium tax credit that lowers the monthly premium of a Marketplace plan. |
Source: HealthCare.gov, federal poverty level glossary.
That is why filling out the Marketplace application makes sense even when you think Medicaid is your lane. The system runs the review and routes you where you belong.
The 2027 dates running against you
Open enrollment started November 1, 2026. December 15 is the last day to enroll or change plans for coverage starting January 1. January 15 is the last day of open enrollment. If you enroll between December 16 and January 15, coverage starts February 1.
Signing up on January 10 does not give you January coverage: coverage starts February 1, and that one month matters when you have an appointment booked or a prescription to refill. You can check the full open enrollment period calendar and compare it with what HealthCare.gov publishes.
Medicaid carries no calendar pressure. If your case goes that way, December 15 does not touch you.
What changes in 2027 for immigrants
Starting January 1, 2027, according to HealthCare.gov, only these immigration statuses may qualify for income-based savings in the Marketplace: lawful permanent resident (Green Card holder), Cuban or Haitian entrant and COFA migrant. If your immigration status is something else, review your case with an agent before assuming anything.
Check it with your immigration document in hand, not from memory and not from what someone told you at work.
Frequently asked questions
There are more answers in our health insurance FAQs.
Can I apply for Medicaid and a Marketplace plan at the same time?
You can start with one application. The Marketplace reviews it and, if someone in your household looks eligible for Medicaid or CHIP, it sends your information to the state agency. You can also go straight to the Florida Department of Children and Families. If you qualify for Medicaid, you do not receive Marketplace savings.
Where do I apply for Medicaid in Florida?
Online at ACCESS Florida, the DCF system at myaccess.myflfamilies.com, or by sending the printed form by mail or fax to a Customer Service Center. The DCF determines eligibility. If you receive SSI, Social Security determines it and you qualify automatically. For renewal, the DCF mails a notice 45 days ahead.
What is the coverage gap?
HealthCare.gov describes it this way. In states that did not expand Medicaid, some adults with income below 100% of the federal poverty level end up with no Medicaid and no premium tax credits. They are the ones who do not qualify through disability, age or other reasons. Review each person separately.
If Medicaid is not your path
Univista Insurance does not enroll anyone in Medicaid. That happens with the DCF, and we explain how. If you do not qualify, our licensed agents compare the 2027 Marketplace plans with you: by phone, online or in person at our offices in South and Central Florida, in English or Spanish. Get your free quote.
Talk with a licensed agent and see if you qualify for lower costs.
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